Healthcare Provider Details

I. General information

NPI: 1760527014
Provider Name (Legal Business Name): BUCHELE DRUG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CAULMET AVE
DESMET SD
57231
US

IV. Provider business mailing address

201 CAULMET AVE
DESMET SD
57231
US

V. Phone/Fax

Practice location:
  • Phone: 605-854-3861
  • Fax:
Mailing address:
  • Phone: 605-854-3861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number40001000109846
License Number StateSD

VIII. Authorized Official

Name: DONALD K BUCHELE
Title or Position: OWNER
Credential:
Phone: 605-854-3861